Katarina’s area of expertise is managed healthcare programs, including Medicaid and Medicare Advantage (Part D). She has assisted in performing actuarial work for Medicare Advantage organizations, state government agencies, and other healthcare clients.
Katarina has extensive experience working for public health care program clients, currently including the Mississippi Division of Medicaid and the Arkansas Department of Human Services. She has worked with clients to:
- Develop actuarially sound managed care capitation rates for acute care services for various populations
- Develop FFS rates for behavioral health and home- and community-based services
- Implement risk adjustment models and other risk mitigation strategies in managed Medicaid programs
- Develop custom risk weights and risk scoring algorithms to calculate plan-specific risk scores
- Analyze the impact of changes in payment arrangements on Medicaid managed care programs
- Analyze managed care encounter data for completeness and accuracy, including ongoing communication with health plans to uncover and solve data issues
- Establish strategy around program design and contracting
- Complete waiver-related cost effectiveness and other financial analyses
- Prepare analyses to respond to Medicaid MCO concerns and CMS questions regarding capitation rates
- Prepare Medicare Advantage Part D bids and respond to desk review and audit requests
